U.S. patent application number 15/609740 was filed with the patent office on 2017-09-14 for obturator tip with insufflation pathway.
The applicant listed for this patent is Covidien LP. Invention is credited to Christopher Kelly Evans, Gregory Fischvogt.
Application Number | 20170258494 15/609740 |
Document ID | / |
Family ID | 48782841 |
Filed Date | 2017-09-14 |
United States Patent
Application |
20170258494 |
Kind Code |
A1 |
Evans; Christopher Kelly ;
et al. |
September 14, 2017 |
OBTURATOR TIP WITH INSUFFLATION PATHWAY
Abstract
A surgical access apparatus including a cannula defining an
internal lumen, the cannula having a connection for receiving
insufflation fluid. The apparatus also includes an obturator
assembly, the obturator assembly configured to be inserted through
a cannula so as to define an interstitial space between the cannula
and the obturator assembly. The interstitial space is in fluid
communication with the cannula connection so as to convey the
insufflation fluid. The obturator assembly includes an obturator
shaft having a hollow interior and a tip member at a distal end of
the obturator shaft. The tip member is configured to penetrate
and/or dissect through tissue. The tip member has an outer surface
that defines a channel, the channel being in fluid communication
with the interstitial space to as to convey the insufflation fluid
from a proximal end of the tip member to a distal end of the tip
member.
Inventors: |
Evans; Christopher Kelly;
(Southington, CT) ; Fischvogt; Gregory; (Denver,
CO) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Covidien LP |
Mansfield |
MA |
US |
|
|
Family ID: |
48782841 |
Appl. No.: |
15/609740 |
Filed: |
May 31, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
13905363 |
May 30, 2013 |
9693802 |
|
|
15609740 |
|
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|
|
61656126 |
Jun 6, 2012 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/3454 20130101;
A61B 17/3474 20130101 |
International
Class: |
A61B 17/34 20060101
A61B017/34 |
Claims
1. (canceled)
2. A surgical access apparatus, comprising: a cannula defining an
internal lumen; and an obturator insertable through the internal
lumen of the cannula, the obturator including: an obturator shaft
having a proximal end and a distal end, and defining a first
diameter; and a tip member at the distal end of the obturator
shaft, the tip member having a cylindrical portion defining a
second diameter, wherein the second diameter is greater than the
first diameter, the tip member having an outer surface, the outer
surface defining a linear channel adapted for conducting fluid,
wherein the linear channel extends from a proximal end of the tip
member to a distal most point of the tip member, wherein a flow
path is defined between the proximal end of the obturator shaft and
the distal most point of the tip member.
3. The surgical access apparatus of claim 2, wherein the obturator
is configured to receive an endoscope.
4. The surgical access apparatus of claim 2, wherein at least a
portion of the tip member is transparent.
5. The surgical access apparatus of claim 2, wherein the linear
channel defines a first fluid path that is separate from an
interior of the obturator.
6. The surgical access apparatus of claim 2, wherein the outer
surface of the tip member includes a plurality of linear
channels.
7. The surgical access apparatus of claim 2, wherein an
interstitial space is defined between an outer surface of the
obturator shaft and an inner surface of the internal lumen of the
cannula.
8. The surgical access apparatus of claim 7, wherein a portion of
the linear channel is in fluid communication with the interstitial
space.
9. The surgical access apparatus of claim 2, wherein the cannula
further includes a housing and a cannula shaft, the cannula shaft
including an internal lumen.
10. The surgical access apparatus of claim 9, wherein the housing
includes opposed proximal and distal apertures.
11. The surgical access apparatus of claim 10, wherein the
obturator is insertable through the internal lumen such that at
least a portion of the linear channel extends beyond the distal
aperture.
12. The surgical access apparatus of claim 2, wherein at least one
seal member is disposed in the cannula, and is configured to form a
fluid-tight seal with the obturator shaft inserted
therethrough.
13. The surgical access apparatus of claim 2, wherein the cannula
is configured to be coupled to a source of fluid.
14. The surgical access apparatus of claim 2, wherein the linear
channel is defined by an open proximal end, an open distal end, and
a pair of opposed walls extending therebetween.
15. An obturator configured to be inserted through a cannula, the
obturator comprising: an obturator shaft having a tip member at a
distal end of the obturator shaft, the obturator shaft defining a
first diameter and the tip member including a cylindrical portion
defining a second diameter, the second diameter is greater than the
first diameter, the tip member having an outer surface that defines
a U-shaped linear channel configured to convey fluid from a
proximal end of the tip member to a distal most point of the tip
member.
16. The obturator of claim 15, wherein the obturator shaft has a
hollow interior.
17. The obturator of claim 15, wherein the hollow interior of the
obturator shaft is configured to receive an endoscope.
18. The obturator of claim 15, wherein at least a portion of the
tip member is transparent.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application is a Continuation of U.S. patent
application Ser. No. 13/905,363, filed May 30, 2013. This
application also claims priority to, and the benefit of, U.S.
Provisional Patent Application Ser. No. 61/656,126, filed Jun. 6,
2012, entitled "OBTURATOR TIP WITH INSUFFLATION PATHWAY," the
entire contents of each of which are incorporated herein by
reference.
BACKGROUND
[0002] Technical Field
[0003] The present disclosure relates to a surgical access assembly
including an obturator and a cannula. More particularly, the
present disclosure relates to an obturator including a tip member
with an outer surface having at least one channel for transmitting
fluids therealong.
[0004] Background of Related Art
[0005] Minimally invasive procedures are continually increasing in
number and variation. Forming a relatively small diameter,
temporary pathway to the target site is a key feature of most
minimally invasive surgical procedures. The most common method of
providing such a pathway is by inserting an access assembly through
the skin. Common access assemblies generally include a cannula
configured to accommodate a trocar for penetrating tissue, and an
obturator for dilating and creating a pathway through tissue.
Obturators may be blunt members that are inserted through the
cannula to tunnel a path through tissue and subsequently to a
selected surgical site.
[0006] Minimally invasive procedures often supply insufflation
fluids, e.g., carbon dioxide, to a body cavity underlying a layer
of tissue such that the layer of tissue lifts away from underlying
tissue or organ structures to create a larger working space. To
this end, a source of insufflation fluid may be coupled to the
cannula such that insufflation fluids flow distally into a body
cavity. In many procedures, it is desirable to insufflate the body
cavity of a patient while the obturator is inserted through the
cannula. In such an arrangement, insufflation fluids may be
introduced through an interior portion of the obturator, and exit
through an opening in a distal portion or tip of the obturator
within the working space. Such an arrangement typically
incorporates an additional source of insufflation fluid coupled
with the obturator, as well as sealing member within the obturator
to inhibit the proximal migration of insufflation fluids through
the obturator.
SUMMARY
[0007] The present invention, in accordance with various
embodiments thereof, is directed to a surgical access apparatus,
comprising: a cannula including a housing and a cannula shaft, the
cannula shaft defining an internal lumen; and an obturator
insertable through the internal lumen of the cannula, the obturator
including: an obturator shaft having a proximal end and a distal
end, and defining a longitudinal axis; and a tip member at the
distal end of the obturator shaft, the tip member configured to be
inserted through tissue and having an outer surface, the outer
surface defining a channel for insufflation fluid.
[0008] The obturator may be configured to receive within an
interior space thereof an endoscope, and at least a portion of the
tip member, or even the entire tip member, may permit light to be
transmitted therethrough so as to provide for an optical obturator.
Advantageously, the channel is not in fluid communication with an
interior of the obturator so as to avoid the need for a seal
between the obturator and the endoscope. In an embodiment, a distal
most end of the channel is at or adjacent to a distalmost end of
the tip member so as to enable insufflation fluids to begin to be
introduced into the body cavity almost immediately upon the distal
tip of the tip member penetrating through the wall of the body
cavity, reducings the likelihood that an injury to underlying
anatomical structures will occur and further improving patient
safety.
[0009] The outer surface of the tip member may define a plurality
of channels. When the obturator shaft is disposed in the lumen of
the cannula shaft, an annular space may be defined between the
obturator shaft and the cannula shaft. A portion of the channel may
be in fluid communication with the annular space. In addition, when
the obturator is inserted in the lumen of the cannula shaft, at
least a portion of the channel may extend distally of the cannula
shaft. Still further, at least one seal member may be disposed in
the cannula. Such a seal may be configured to form a fluid-tight
seal with the obturator inserted therethrough. The cannula may be
configured to be coupled to a source of fluid. The channel may be
defined by an open proximal end, an open distal end, and a pair of
opposed walls extending therebetween.
[0010] In other embodiments, the present invention may be directed
to an obturator assembly that is configured to be inserted through
a cannula. The obturator assembly may comprise an obturator shaft
having a tip member at a distal end of the obturator shaft, the tip
member configured to at least one of penetrate and dissect through
tissue, the tip member having an outer surface that defines a
channel, the channel configured to convey insufflation fluid from a
proximal end of the tip member to a distal end of the tip
member.
[0011] The obturator may have a hollow interior, and the hollow
interior of the obturator may be configured to receive an
endoscope. At least a portion of the tip member may permit light to
be transmitted therethrough, and in various embodiments, the entire
tip member may be light transmissible so as to provide an optical
obturator.
[0012] In other embodiments, the present invention may be directed
to a surgical access apparatus, comprising a cannula including a
housing and a cannula shaft, the cannula shaft defining an internal
lumen, the cannula having a connection for receiving insufflation
fluid; and an obturator assembly, the obturator assembly configured
to be inserted through a cannula so as to define an interstitial
space between the cannula and the obturator assembly, the
interstitial space being in fluid communication with the cannula
connection so as to convey the insufflation fluid received by the
connection, the obturator assembly including an obturator shaft
having a hollow interior and a tip member at a distal end of the
obturator shaft, the tip member configured to at least one of
penetrate and dissect through tissue, the tip member having an
outer surface that defines a channel, the channel being in fluid
communication with the interstitial space to as to convey the
insufflation fluid from a proximal end of the tip member to a
distal end of the tip member, the channel not being in fluid
communication with the interior of the obturator. In various
embodiments, at least a portion of the tip member may permit light
to be transmitted therethrough. Advantageously, the entire tip
member may be fabricated from a material that permits light to be
transmitted therethrough, thereby providing an optical obturator
for use with the endoscope.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] The accompanying drawings, which are incorporated in and
constitute a part of this specification, illustrate embodiments of
the disclosure and, together with a general description of the
disclosure given above, and the detailed description of the
embodiment(s) given below, serve to explain the principles of the
disclosure, wherein:
[0014] FIG. 1 is a perspective view of an obturator including a tip
member in accordance with the present disclosure;
[0015] FIG. 2 is an enlarged view of the area of detail identified
in FIG. 1;
[0016] FIG. 3 is a bottom plan view of the obturator shown in FIG.
1;
[0017] FIG. 4 is a side view of the obturator shown in FIG. 1;
[0018] FIG. 5 is a cross-sectional view taken along section line
5-5 of FIG. 4;
[0019] FIG. 6 is a cross-sectional view taken along section line
6-6 of FIG. 4;
[0020] FIG. 7 is a perspective view of the cross-section taken
along section line 6-6 of FIG. 5;
[0021] FIG. 8 is a perspective view of a surgical access apparatus
according to the present disclosure, including the obturator of
FIG. 1;
[0022] FIG. 9 is a cross-sectional view taken along section line
9-9 of FIG. 8, shown together with a cross-section of a layer of
tissue and underlying body cavity;
[0023] FIG. 10 is an enlarged view of the area of detail identified
in FIG. 9;
[0024] FIG. 11 is a cross-sectional view taken along section line
9-9 of FIG. 8, shown together with a cross-section of a layer of
tissue and underlying insufflated body cavity;
[0025] FIG. 12 is an enlarged perspective view of a tip member
according to an alternative embodiment of the present disclosure;
and
[0026] FIG. 13 is an enlarged perspective view of a tip member
according to another alternative embodiment of the present
disclosure.
[0027] The figures depict preferred embodiments of the present
disclosure for purposes of illustration only. One skilled in the
art will readily recognize from the following discussion that
alternative embodiments of the structures and methods illustrated
herein may be employed without departing from the principles of the
present disclosure described herein.
DETAILED DESCRIPTION
[0028] Embodiments of the presently disclosed surgical access
apparatus for use in minimally invasive procedures are described in
detail with reference to the drawings, in which like reference
numerals designate identical or corresponding elements in each of
the several views. As used herein, the term "distal" refers to that
portion of the apparatus which is farther from the operator while
the term "proximal" refers to that portion of the apparatus which
is closer to the operator. The presently disclosed surgical access
apparatus is usable in an opening through a patient's tissue, such
as an incision or a naturally-occurring orifice (e.g., mouth, anus,
or vagina).
[0029] Referring initially to FIG. 8, a surgical access apparatus
1000 is shown. Surgical access apparatus 1000 includes an obturator
100 insertable through a cannula 200, which will be described
further in detail below.
[0030] Referring now to FIG. 1, obturator 100 includes an obturator
shaft 102, a tip member 110, and a handle 108. Obturator shaft 102
is an elongate member that defines a longitudinal axis "A", and has
a proximal end 104 and a distal end 106. A handle 108 is mounted to
the proximal end 104 of obturator shaft 102 and may include surface
features suitable for grasping by an operator, e.g., an ergonomic
grip incorporating flanges, curves, knurls, or the like.
[0031] Turning to FIG. 2, tip member 110, as shown, may have a
tapered, e.g., conical, pyramidal, curved, etc., configuration that
tapers to a distal tip 112. Distal tip 112 may be blunt, as shown,
or may have another desirable atraumatic configuration, e.g.,
curvate, spheroid, or flat. In other embodiments, distal tip 112
may be sharpened or pointed so as to be configured to penetrate
tissue.
[0032] A channel 120 may be formed on an outer surface of the tip
member 110. Channel 120, as shown, is contoured to the outer
surface of tip member 110 and extends along the length of tip
member 110. Channel 120 includes an open proximal end 122 opposite
an open distal end 124. Distal end 124 may be coterminous with
distal tip 112, or distal tip 112 may protrude past the distal end
124 of channel 120, as shown. Channel 120 is defined by a pair of
opposed walls 126 joined by a channel floor 128. Channel 120 may
have any desirable configuration, e.g., arcuate or U-shaped, or may
be configured as a closed member extending along the tip member
110, e.g., a tube or box when viewed in cross-section. Channel 120
defines a path through which fluids, e.g., insufflation fluids, may
flow. In further embodiments, the walls 126 or channel floor 128
may incorporate surface features such as grooves or curves, e.g.,
to direct or alter fluid flow through channel 120. Tip member 110
may include any number or configuration of channels 120.
[0033] In some instances, the outer diameter of the obturator 100
may closely match the inner diameter of cannula 200. Thus, in some
embodiments, channel 120 may extend along the entire length of
obturator 100 or substantially the entire length of obturator 100.
The channel 120 may be fluidly coupled directly to insufflation
port 214 (FIG. 8).
[0034] Channel 120 may be formed on an outer surface of tip member
110 by, e.g., cutting, etching, laser treatment, electrical arcing,
and the like. In embodiments, tip member 110 may be molded in a die
or template such that channel 120 is pre-formed. Those skilled in
the art of the present disclosure will envision other suitable
methods of forming channel 120.
[0035] Referring additionally to FIG. 3, channel 120, as shown,
extends radially inward at a depth "D" along the outer surface of
the tip member 110. Depth D, as shown, may be a constant dimension
measured radially inward from an outer surface of the tip member
110. In this manner, channel floor 128 is disposed a depth D from
the outer surface of tip member 110 as the channel 120 extends
along the tapered profile of the tip member 110 toward the distal
tip 112. In embodiments, the depth D of channel 120 may vary along
the longitudinal length of the tip member 110, e.g., the distance
between the outer surface of the tip member 110 and the channel
floor 128 may increase or decrease along the longitudinal length of
tip member 110.
[0036] Referring now to FIGS. 4 and 5, tip member 110 is shown
coupled with obturator shaft 102. Tip member 110 may be mounted to
the distal end 106 of obturator shaft 102 by any suitable means,
e.g., press-fit, threaded connection, bayonet-type coupling,
adhesion, or ultrasonic welding. In embodiments, tip member 110 and
obturator shaft 102 may be integrally formed. Additionally, tip
member 110 may be overmolded about a pre-existing tip member, or
one or more channels 120 may be formed on a pre-existing tip member
in the manner described above. Accordingly, tip member 110 may be
configured and dimensioned to be retrofitted to a number of
existing devices and obturators.
[0037] Referring additionally to FIGS. 6 and 7, the open proximal
end 122 of channel 120 provides an entrance path to channel 120 as
a fluid, e.g., insufflation fluid, advances distally along the
obturator shaft 102 toward the tip member 110. Tip member 110, as
shown, may have a hollow interior, or may be a solid member. In
embodiments, tip member 110 may incorporate a transparent region or
optical window through which light may pass, allowing for
visualization or illumination outside the tip member 110 with an
endoscope or other viewing device (not shown).
[0038] Turning now to FIGS. 8 and 9, the obturator 100 is
configured for insertion through cannula 200. Cannula 200 includes
a housing 210 and a cannula shaft 220 extending distally from the
housing 210. Housing 210 defines an interior annular recess and
includes a proximal end 211 and a distal end 212 each defining an
aperture configured to accommodate insertion of the obturator shaft
102 therethrough. Cannula shaft 220 has an open proximal end 221
opposite an open distal end 222, and defines an internal lumen 224
extending from the proximal end 221 to the distal end 222. Lumen
224 is dimensioned to accommodate passage of the obturator shaft
102 and tip member 110 through the cannula shaft 220.
[0039] A seal member 218, as shown, may be disposed within housing
210. Seal member 218 may be press fit, adhered, welded, or
otherwise secured within housing 210. Seal member 218 is configured
to sealably engage obturator shaft 102, or an instrument inserted
therethrough. Accordingly, seal member 218 may be configured as a
septum, conical, or disc seal. In embodiments, seal member 218 may
be configured as a zero-closure seal, e.g., a duckbill, and may be
configured to inhibit the proximal migration of fluids through
cannula 200 in the absence of an instrument inserted therethrough.
In further embodiments, cannula 200 may incorporate multiple seal
members of varying configurations. Such seal members may be
disposed in either or both the cannula housing 210 or cannula shaft
220.
[0040] Obturator 100, as shown, is insertable through lumen 224 of
cannula shaft 220. Obturator 100 is dimensioned such that upon
engagement of the handle 108 with the proximal end 211 of housing
210 of cannula 200, a portion of tip member 110 and channel 120 is
exposed distally of the cannula shaft 220. At least a portion of
tip member 110 remains disposed within lumen 224, as will be
described further below.
[0041] Housing 210, as shown, includes an insufflation port 214 for
transmitting fluids, e.g., insufflation fluids, therethrough.
Insufflation port 214 may be configured as a stopcock or other
suitable fluid port. Insufflation port 214 may be coupled with,
e.g., a source of insufflation fluid or vacuum, or to a fluid line
connected to a fluid source. Insufflation port 214 may include a
valve 215 or fluid lock for selectively controlling the flow of
fluids through insufflation port 214.
[0042] A pair of tabs 216 extends radially outward from an outer
surface of the housing 210. Tabs 216 are suitable for grasping by
an operator, e.g., the ring and index finger of one hand. Thus,
tabs 216 provide an ergonomic grip such that an operator may grasp
tabs 216 together with the handle 108 of obturator 100 to
facilitate translation of the obturator 100 relative to the cannula
200. In this manner, an operator may also move the entire surgical
access apparatus 1000.
[0043] With continued reference to FIG. 9, the surgical access
apparatus 1000, as shown, is configured to be inserted through a
layer of tissue "T". Tissue T defines a body cavity "BC", which may
include underlying structures "S", such as tissue or body
organs.
[0044] FIG. 10 illustrates an initial penetration or incision of
tissue T. An operator may grasp handle 108 of obturator 100 and
tabs 216 of cannula 200 (FIG. 8), and, upon distal movement of
obturator 100, tip member 110 dilates and advances through tissue
T, creating a path for cannula shaft 220 to be inserted through
tissue T. Cannula shaft 220 may include one or more visual
indicator(s) to indicate the position of cannula 200 within the
tissue. For instance, the visual indicator(s) may inform a user as
to when the entire distal end 222 is within the incision. Thus, the
user would know that surgical access apparatus 1000 is in a
position where insufflation gas would be effectively trapped by the
tissue and retained within the insufflation channel 120.
[0045] Insufflation fluids "F" are introduced through insufflation
port 214 and into lumen 224 of cannula shaft 220. The presence of
the obturator shaft 102 within lumen 224 defines an annular space
through which insufflation fluids F flow. Seal member 218, as
described above, inhibits the proximal migration of insufflation
fluids F through the cannula shaft 220. Accordingly, pressurized
insufflation fluids F entering cannula 200 through insufflation
port 214 advance distally through lumen 224 toward tip member
110.
[0046] A proximal portion of channel 120, as shown, is disposed
within and in fluid communication with lumen 224. With additional
reference to FIG. 7, the proximal end 122 of channel 120 is exposed
within the lumen 224 such that insufflation fluids F may enter
channel 120 and advance distally into body cavity BC. As
pressurized fluids F build up within lumen 224, channel 120
provides a path of least resistance along which pressurized
insufflation fluids F will escape the higher-pressure environment
within lumen 224. Accordingly, controlling the rate of flow through
insufflation port 214 affects the fluid pressure within lumen 224
and the subsequent flow of insufflation fluids F along channel 120
and into body cavity BC.
[0047] In this manner, the supply of insufflation fluids F to body
cavity BC is achieved directly through the cannula 200. The passage
of insufflation fluids F along an outer surface of the tip member
110 of obturator 100 obviates the need for an additional
insufflation supply and accompanying sealing structure for
obturator 100, as will described in further detail below.
[0048] The introduction of pressurized insufflation fluids F into
body cavity BC creates an insufflated workspace such that tissue T
may be lifted away from underlying structures S (FIG. 9). As shown
in FIG. 10, the positioning of the distal end 124 of the channel
120 at or near the distal end of the tip member 110 enables
insufflation fluids to begin to be introduced into the body cavity
almost immediately upon the distal tip of the tip member
penetrating through the abdominal wall. Accordingly, a larger
working space is created for a minimally invasive procedure such
that further advancement of the obturator 100 safely into body
cavity BC is possible, facilitating, e.g., visualization or
illumination of the body cavity BC, or further dilation of tissue T
or structures S to reach a desired working site. Once the tissue,
e.g, the abdominal wall, has been fully penetrated (see, e.g, FIG.
11), the obturator 100 may be withdrawn from the cannula 200, and
another instrument (not shown) may be inserted through the cannula
200. As described above, the seal member 218 may be configured to
maintain insufflation fluids F within body cavity BC in the absence
of obturator 100 or another instrument.
[0049] Turning now to FIG. 12, an alternative embodiment of a tip
member according to the present disclosure, designated tip member
310, is shown. Tip member 310 includes a channel 320 that is
substantially similar to channel 120 described above. Each of side
channels 322, 324 includes a proximal portion in parallel relation
with channel 320, and a distal portion that curves toward and
merges with channel 320 at an intersection 326 along the surface of
tip member 310. Channel 320 and side channels 322, 324 are in fluid
communication such that insufflation fluids F (FIG. 9) entering any
of channel 320 or side channels 322, 324 will reach a distal
portion of channel 320 at intersection 326. Accordingly,
insufflation fluids F may be supplied to a distal portion of
channel 320 through any of side channels 322, 324, or directly
through a proximal portion of channel 320 to reach a body cavity BC
(FIG. 9). In this manner, several paths are provided for
insufflation fluids F to exit lumen 224 (FIG. 9) and reach body
cavity BC such that an obstruction of one path does not inhibit the
insufflation of body cavity BC. In further embodiments, tip member
310 may include any number or configuration of side channels.
[0050] Turning now to FIG. 13, a further embodiment of a tip member
according to the present disclosure, designated 410, is shown. Tip
member 410 includes a proximal end 412 and a distal end defined by
a distal tip 414. A channel 420 is formed on an outer surface of
the tip member 410, and has a similar configuration to channel 120
described above. Channel 420 includes an open proximal end 422
coincident with the proximal end 412 of tip member 410, and an open
distal end 424. Channel 420 extends a portion of the longitudinal
length of tip member 410 such that the open distal end 424 of
channel 420 is spaced proximally away from the distal tip 414 of
tip member 410. Accordingly, the path defined by channel 420 is
contoured about a portion of the outer surface of tip member 410,
and insufflation fluids F (FIG. 9) advancing through channel 420
exit the open distal end 424 of channel 420 at a distance
longitudinally and radially spaced away from the distal tip 414. In
this manner, the flow profile of insufflation fluids F may be
controlled, e.g., to reach outlying structures S (FIG. 9) or to
disperse insufflation fluids F over a wider area.
[0051] The present invention may provide various advantages over
conventional arrangements, such as the use of a veress needle to
introduce insufflation fluids. As shown in FIG. 10, the positioning
of the distal end 124 of the channel 120 at or near the distal end
of the tip member 110 enables insufflation fluids to begin to be
introduced into the body cavity almost immediately upon the distal
tip 112 of the tip member 110 penetrating through the abdominal
wall. By eliminating the use of a veress needle, this arrangement
minimizes the likelihood that an injury to underlying anatomical
structures will occur. The introduction of pressurized insufflation
fluids F into body cavity BC in order to create an insufflated
workspace (which is typically a requirement of laparoscopic
surgeries such that tissue T may be lifted away from underlying
structures S) is performed much more safely than with a
conventional veress needle.
[0052] Still further, the present invention may provide various
advantages over conventional arrangements such as certain optical
obturators. For example, there exist optical obturators that
receive endoscopes therein; these optical obturators may include
holes along their shafts or at their proximal ends for allowing
insufflation fluid to enter the hollow interior of the optical
obturator, as well as holes near the distal end thereof for
expelling the insufflation fluids from the hollow interior and into
a body cavity. While these distally located holes may provide for
the flow of insufflation fluids, they are located more proximally
relative to its respective distal most tip than may be achieved by
the positioning of the distal end 124 of the channel 120, and thus
the distal most tip of these conventional optical obturators must
be inserted farther into a body cavity in order for insufflation
fluids to begin to flow into the body cavity. By needing to be
inserted farther into a body cavity prior to insufflation fluids
beginning to flow into the body cavity, these conventional optical
obturators have a higher risk of inadvertently damaging the
underlying anatomical structures.
[0053] In contrast, in various embodiments of the present
invention, the distal end 124 of the channel 120 may be positioned
at the distal most end of the tip member 110. This arrangement
enables insufflation fluids to begin to be introduced into the body
cavity almost immediately upon the distal tip of the tip member
penetrating through the abdominal wall, and earlier than would be
possible in such above-described conventional optical obturators.
This further reduces the likelihood that an injury to underlying
anatomical structures will occur and further improves patient
safety.
[0054] An additional advantage of the present invention as compared
to above-described conventional optical obturators is that the
provision of channels on the outer surface of the tip member may
help avoid problems that are caused by the arrangements of the
conventional optical obturators, e.g., that have holes that are in
fluid communication with the hollow interior of the obturator. The
above-described conventional optical obturators receive endoscopes
in their hollow interiors, and thus having holes in the obturator
walls as they do requires that a seal be provided in the interior
of the obturator, e.g., at the proximal end thereof, in order to
prevent the proximal flow and escape of insufflation gas between
the interior wall of the obturator and the outer surface of the
endoscope. This seal adds costs and complexity to the manufacture
of this conventional optical obturator, as well as provides another
potential leak path during a surgical procedure.
[0055] In contrast, the provision of channels on the outer surface
of the tip member, as described hereinabove in connection with the
present invention, avoids the need for a seal in the interior of
the obturator. Since the channels are not in fluid communication
with the hollow interior of the obturator, insufflation fluids that
enter into the annular space within the cannula do not enter the
interior of the obturator, and thus there is no possibility that
the insufflation fluids will flow proximally and escape between the
interior wall of the obturator and the outer surface of the
endoscope. Rather, insufflation fluids flow only through the
channel 120 and into the body cavity, and an endoscope that is
inserted within the optical obturator need not be sealed relative
thereto.
[0056] A still further advantage of the present invention as
compared to the above described conventional optical obturators is
that the provision of channels on the outer surface of the tip
member may help avoid the need for other seals that are employed in
the above-described conventional optical obturators. For example,
these conventional optical obturators may also include a seal at
the distal end of the cannula tube, this distal cannula seal
sealing between the cannula tube and the outer surface of the
obturator. Such a seal is typically necessary such that
insufflation gas received via the cannula housing is directed first
through the holes in the optical obturator and into the interior of
the optical obturator and then out of the interior through the
distal most hole of the obturator. Without the distal cannula seal,
insufflation gas received via the cannula housing would attempt to
be expelled out of the distal end of the cannula tube, between the
inner wall of the cannula tube and the outer surface of the
obturator, but would be prevented from doing so because of the
direct contact between the tip of the optical member and the
tissue. Again, this distal cannula seal adds costs and complexity
to the manufacture of this conventional optical obturator, as well
as provides another potential leak path during a surgical
procedure.
[0057] In contrast, the provision of channels on the outer surface
of the tip member, as described hereinabove in connection with the
present invention, avoids the need for this distal cannula seal. In
various embodiments of the present invention, insufflation gas
received via the cannula housing is expelled out of the distal end
of the cannula tube, between the inner wall of the cannula tube and
the outer surface of the obturator. However, instead of being
prevented from being expelled because of the direct contact between
the tip of the optical member and the tissue (as is the case with
the above-described conventional optical obturators), the provision
of the channel or channels on the outer surface of the tip member
provide a path for such insufflation gas to flow, and specifically
a path to the distalmost tip of the tip member so as to be expelled
into a body cavity immediately as the wall of the body cavity is
penetrated.
[0058] The present invention, according to various embodiments
thereof, may also provide the advantage that it requires virtually
no modifications of the various components of a trocar. As set
forth above, not only must the above-described conventional optical
obturators provide two additional seals (a first seal between the
interior surface of the optical obturator and the endoscope; and a
distal cannula seal between the interior surface of the cannula
tube and the outer surface of the optical obturator), but almost
all of the components of this system are required to be re-designed
as compared to an ordinary trocar in order to accommodate these
seals and the desired flow of insufflation gas into the interior of
the optical obturator. In contrast, every component of the system
of the present invention save the tip member, may--if
desired--remain completely unchanged from an ordinary trocar,
thereby saving costs and enabling the advantages of the present
invention to be provided simply by providing a channeled tip member
on an ordinary trocar system, without requiring modification of the
remaining components of the trocar system.
[0059] It will be understood that various modifications may be made
to the embodiments disclosed herein. Therefore, the above
description should not be construed as limiting, but merely as
exemplifications of embodiments. Those skilled in the art will
envision other modifications within the scope and spirit of the
present disclosure.
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